The Association Between Major Mental Disorders and Geniuses

There are many [awe-inspiring] wonders, none greater than a human being.

—Sophocles, Chorus in Antigone

There exists an association between creativity and major mental disorders known since antiquity. The ancient Greeks considered both as “having been touched by the gods.” Aristoteles, in his perspicacity, stated, “There is no genius without having a touch of madness.” This phenomenon has been verified repeatedly in studies in the past.1-4 Does one phenomenon cause the other or do both share a common underlying factor or mechanism? How are geniuses able to accomplish “creative fits”? In this article, both questions are addressed.

Although the proposed origin and mechanism of the brain function of creative geniuses is novel, empirical evidence is available to support this theory. Empirical evidence demonstrates that creativity and major mental disorders share a common pool made up of individuals with an extreme temperamental variant who, if endowed with other qualities (eg, high intelligence, tenacity, curiosity, energy) and live in a nurturing and complementary zeitgeist, can be creative geniuses. On the other hand, persons with a similar temperament but who do not have the additional qualities form a common pool of individuals who are at increased risk for a major mental disorder.5

Temperament

A few remarks regarding temperament are warranted, since they are cogent and relevant to the discussion in this article. Temperament is defined as the particular inborn behavioral propensities for each individual, which ultimately represents the final brain structural reality. It not only acts as an unfinished scaffold upon which the personality of the individual is formed, but it also guides the significance of environmental influences that are eventually embedded in the scaffold. Both constitute, along with learned attitudes and ethos, the final personality of the individual.

Temperamental components appear to originate from two areas from our evolutionary past and are expressed in distinct clusters. The first cluster originates from the evolutionary pressures on the individual, expressed as selfishness, inner directness, aloofness, and self-serving calculations. The second area/group originates from the evolutionary pressures on the social aspects of human experience, such as sociability, connectedness, empathy, altruism, mutuality, cooperation, and loyalty to one’s tribe (ie, tribalism). These two unamalgamated clusters make up human nature.6,7

From an evolutionary standpoint, the normally occurring small temperamental variability, or traits, confers flexibility and resilience for the survival of the tribe as a whole, irrespective of advantage or even disadvantage to the individual. Importantly, the mix of the temperamental components are often not distributed evenly but appear as clusters originating mainly from one or the other part of our human nature. This creates the often lopsided temperamental types (eg, the extrovert and the introvert).

In creative geniuses, there exists a major variation from the norm of the inborn temperament. This variant lies beyond the normally occurring variability. Referring to major mental disorder, Freud called it “narcissistic neuroses.”8 This extreme variant is also seen in other individuals at risk for major mental disorders. When and if a major mental disorder does develop (probabilistically amenable to prediction only by statistical methods), the individual’s preexisting lopsided traits manifest as premorbid personality.5

Findings from clinical empirical evidence indicate that this extreme variant originates mainly from evolutionary pressures and is shared by potential geniuses and other vulnerable individuals. Schizophrenia, bipolar disorder, and obsessive-compulsive disorder are the 3 conditions that develop most frequently in vulnerable individuals. These conditions can overlap or switch from one to another. Relapses have traditionally been attributed to comorbidity; however, each syndrome might be considered as a different phase of the same disorder. Clinical evidence points to a common neurodevelopmental origin for all three.9 Similar results have also been seen in recent genetic studies.10

These individuals are to various degrees less social, more self-centered, and aloof. They may exhibit remarkable “learned” affability and civility, but they are, to various degrees, inner-directed, autonomous, and deficient in empathy and connectedness. They tend to “think” the world rather than “feel” it. Persons with this temperament, behave oddly and are often perceived as fickle, idiosyncratic, peculiar, or strange. They are often dysphoric and tend to feel an “inner void, and aloneness within.”

Occasionally this progresses to episodes of precipitous depression and can lead to suicide or substance abuse. These individuals exhibit a kind of “Robinson Crusoe of the spirit,” although as in the case of talented performers, it may generate great merriment, affection, and enthusiasm in their audience (an example might be the recent death of the much-loved actor Robin Williams). These individuals are racked by doubts and mood oscillations, and they are often captives of compulsive rituals.

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Dr Pediaditakis practices psychiatry full-time, consults, and writes articles and poetry. He raises Black Angus cattle as a hobby. He reports no conflicts of interest concerning the subject matter of this article.

10. Cross-Disorder Group of the Psychiatric Genomic Consortium. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis [published correction appears in Lancet. 2013;381:1360]. Lancet. 2013;381:1371-1379.